单孔微型钢板内固定治疗第1掌指关节侧副韧带损伤伴骨折

目的:探讨应用单孔微型钢板内固定治疗第1掌指关节侧副韧带损伤伴骨折的临床效果。方法:应用单孔微型钢板内固定治疗第1掌指关节侧副韧带损伤伴骨折共22例,男16例,女6例;年龄18～53岁,平均28.5岁。受伤至手术时间2 h～2个月,平均6 d.均为第1掌指关节侧副韧带损伤伴骨折,右手13例,左手9例。闭合伤18例,开放伤4例。新鲜损伤(<2周)18例,陈旧损伤(>2周)4例。拇指近节基底尺侧副韧带损伤伴骨折16例,桡侧副韧带损伤伴骨折6例,其中同时伴拇短展肌、拇短屈肌腱止点损伤4例。撕脱骨折块大小为3.0 mm×4.0 mm～6.0 mm×7.0 mm.结果:22例术后切口均Ⅰ期愈合,随访6个月～5年,平均2.5年。根据Saetta等疗效评定标准评价拇指功能,优20例,良2例。结论:应用单孔微型钢板内固定治疗第1掌指关节侧副韧带损伤伴骨折是一种行之有效的方法。

Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture

Objective:To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture. Methods:Twenty-two patients (16 males,6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months,and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (<2 weeks) and 4 had old injuries(>2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture,6 patients had radial collateral ligament injuries of the thumb combined with fracture,4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm×4.0 mm to 6.0 mm×7.0 mm. Results:The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria,and 20 patients got an excellent result and 2 good. Conclusion:The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.